Provider Demographics
NPI:1174273411
Name:BYSTRICKY, ANNA ELISE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ELISE
Last Name:BYSTRICKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MACNIDER HALL, CAMPUS BOX #7593
Mailing Address - Street 2:333 SOUTH COLUMBIA STREET
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599
Mailing Address - Country:US
Mailing Address - Phone:919-966-6770
Mailing Address - Fax:919-966-8419
Practice Address - Street 1:UNC-CHAPEL HILL
Practice Address - Street 2:101 MANNING DRIVE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599
Practice Address - Country:US
Practice Address - Phone:919-966-6770
Practice Address - Fax:919-966-8419
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program